Blood Transfusion
Information for Patients
Healthiest people ~ Healthiest communities ~ Exceptional service
Published by:
Transfusion Medicine Laboratory
Saskatoon Health Region
© 2010 Saskatoon Health Region
2
Table of Contents
Introduction .................................................................................................... 4
What is blood? ............................................................................................... 4
What is a blood transfusion?........................................................................ 5
When would I receive a blood transfusion? ............................................. 6
What are blood products? .......................................................................... 6
Are there other products that I might receive? ....................................... 7
What happens if I need a blood transfusion or a blood product? ...... 8
Where does the blood transfusion or blood product come from? ...... 9
What are the risks of being transfused?..................................................... 9
Are there any alternatives to having a blood transfusion? ................. 11
Does artificial blood exist? ......................................................................... 12
Can I donate my own blood? .................................................................. 12
Can I donate for a family member or friend? ........................................ 13
How will I know if I received a transfusion? ............................................. 13
I never knew that blood was so important! ............................................ 14
Contact Information ................................................................................... 15
Bibliography .................................................................................................. 15
Notes or Questions to Ask My Physician .................................................. 16
3
Introduction
Blood transfusions are an important part of healthcare. In 2007 in
Saskatchewan, more than 33,000 units of red blood cells and over
53,000 blood products were given to people who needed them!
Receiving blood in Canada is very safe and there is little risk of
complications from transfusions. While most people who are
hospitalized won’t need a blood transfusion, your doctor feels that it
is important for you to be informed about blood transfusions and
blood products.
This booklet will explain:

What a blood transfusion is.

The benefits and risks associated with blood transfusions.

Possible alternatives to having a blood transfusion.
If your doctor recommends a blood transfusion as part of your
medical treatment, you (or your family) will be asked to give consent.
It is very important that you understand what you are agreeing to. If
you have any questions, concerns, or need clarification on some of
the information found in this booklet, ask your doctor.
What is blood?
Although it seems to be a simple fluid, blood is complicated. The fluid
portion is called plasma. Three major types of cells float within the
plasma:
1.
Red Blood Cells – The first type of
blood cell is called the red blood cell.
These cells are red and give blood its
characteristic colour. Red blood cells
carry oxygen from the lungs to all the
other parts of the body.
2.
White Blood Cells – The second type
of blood cell is the white blood cell.
There are several types of white blood cells. They are
important in fighting infections.
4
3.
Platelets – The third type of blood cell is the platelet. Platelets
are the smallest of the blood cells. When injuries occur to the
blood vessels, platelets act to “plug the hole” in the blood
vessel and stop the bleeding.
The plasma also contains three types of proteins, including:
1.
Albumin is the most common type of protein in the plasma. It is
made by the liver. It carries nutrients and hormones around
the body.
2.
Immunoglobulins (also known as antibodies) are proteins that
recognize foreign organisms that have invaded the body. They
destroy these “germs”.
3.
Clotting Factors are a group of proteins that help stop bleeding
when we are injured.
What is a blood transfusion?
Whole blood is separated into its different parts (plasma and cells)
shortly after it is collected from donors at Canadian Blood Services. A
transfusion could include:

Red Blood Cells

Plasma

Platelets

Blood Fractionation Products (which are processed
from the plasma)
This way, you only receive what you need! When people talk about
“blood transfusions” they mean transfusions of red blood cells.
However, in reality red blood cells account for only 40% of what is in
blood – the rest is plasma and platelets.
Doses of red blood cells, plasma and platelets for transfusion are
packaged in special bags made out of polyvinyl chloride (PVC).
Each dose is referred to as a unit. Red blood cell, plasma and
platelet transfusions are given through a needle placed into a vein in
the patient’s arm.
5
When would I receive a blood transfusion?
Red blood cell transfusions are usually given to patients who don’t
have enough of their own red blood cells. They may have lost blood
during surgery or in an accident. Some people have diseases that
cause their bodies to destroy their own red blood cells. If you have
lost a large number of red blood cells, you won’t be able to carry
enough oxygen from your lungs to the rest of your body. A transfusion
of red blood cells will restore your body’s ability to carry oxygen.
Platelet transfusions are usually given
when patients are at risk of bleeding.
This may be because they have either
reduced numbers of platelets in their
blood or reduced platelet function.
Plasma transfusions are given when
patients require albumin, clotting
factors or immunoglobulins.
What are blood products?
Your doctor may recommend that you receive a blood product. This
may be in addition to, or instead of, a blood transfusion. Blood
products are medications that are made from human blood. Blood
products are also called fractionation or plasma products. Blood
products commonly prescribed for patients in the hospital include:

Cryoprecipitate is a plasma concentrate that contains
clotting factors.

Albumin is a protein made by the liver and is transfused to
patients with burns or low blood pressure.

Intravenous Immune Globulin (IVIG) is a solution that
contains high levels of immunoglobulin (antibodies). Like
albumin, this product is made from blood. It is given to
people who don’t have enough antibodies of their own to
prevent infections and to patients who have low immunity.
There are many other reasons that your doctor may order
IVIG for you. Like albumin, IVIG is specially treated to fight off
any disease-causing viruses.

Rh Immune Globulin, also called WinRho®, is a solution
containing high levels of a special antibody. It may be given
6
to pregnant Rh Negative women in their 28 th week of
pregnancy and after they have given birth. It is typically
given as an intramuscular (into the muscle) injection.
WinRho® may also be given intravenously (by a needle
placed into a vein) in selected immune disorders.

Clotting Factors. There are some other special
immunoglobulin solutions that are used to prevent people
from developing a disease after they have been exposed to
it. These medications are derived from blood, and are used
to prevent diseases such as Hepatitis B and chicken pox.
They may be given intramuscular or through a needle
placed in a vein.
People whose bodies do not produce normal amounts of specific
clotting factors may be prone to bleeding. This condition is known as
hemophilia. For hemophiliacs, medications are available which
replace the missing clotting factors and stop the bleeding. These
medications may be either:

Plasma derived medications are made from blood.

Recombinant medications are made in a laboratory and do
not contain any blood. Some of these medications may also
be given rarely to people who are not hemophiliacs in an
attempt to control heavy bleeding.
Are there other products that I might receive?
Your doctor may order a product for you called Pentastarch
(examples are Voluven ® or Pentaspan® ). This product is a clear
liquid that is infused through a needle placed in a vein, just like a
blood transfusion. Pentastarch is a man-made liquid that is not
derived from blood.
7
What happens if I need a blood transfusion or a
blood product?
If your doctor prescribes a blood transfusion or blood products for
you, he or she will explain the benefits and risks of the transfusion or
blood product, and ask you to consent to the treatment. These risks
and benefits will differ depending on what product you are to
receive, and on your illness or condition. If you have any questions
or there is anything that you don’t understand, you should ask
your doctor.
Prior to receiving a transfusion, a sample of your blood will be sent to
the Transfusion Laboratory. Your ABO and Rh blood group will be
determined and double-checked. Your blood will also be screened
for the presence of atypical antibodies. Most people don’t have
these antibodies. However, if you have been transfused before or
you are female and have been pregnant your body may have
produced those antibodies. If you do have them, the Medical
Laboratory Technologists working in Transfusion Medicine will identify
them and carefully search for blood components that are
compatible with your blood and can be safely transfused to you.
Once a unit of red blood cells, plasma or platelets has been selected
for you, it will be labeled with your name and hospital number. When
your doctor requests that it be given to you, your nurse will administer
the unit through a needle placed in your vein. It usually takes
between 30 minutes to a few hours to give blood components.
While you are being transfused, your nurse will observe you closely, in
case you develop a side effect. Most side effects are mild; some are
8
treated with medications like Tylenol® or antihistamines such as
Benadryl®. Reactions to transfusion can occur anytime during the
transfusion or up to 4 to 6 hours after the transfusion. Symptoms may
include headaches, fever, chills, nausea, vomiting, dizziness, hives or
itchy skin. If you have any change from how you felt before the
transfusion, notify the nursing staff immediately.
Where does the blood transfusion or blood
product come from?
Canadian Blood Services (CBS) look after the collection, testing,
processing and storage of blood donations. Blood components (red
blood cells, plasma, platelets and cryoprecipitate) are donated by
people across Canada. Every donation is tested by CBS for
transmissible diseases. It is not released for use until it has been tested.
Blood products such as albumin, intravenous immune globulin and
clotting factors are produced by pharmaceutical companies under
stringent conditions to ensure the highest quality and safest product.
Health Canada regulates and licenses all products manufactured for
Canadian use.
What are the risks of being transfused?
Receiving blood or blood products in Canada is very safe. Serious
complications are rare. Some of these rare, but serious,
complications are:

Developing serious infection from bacteria in the transfusion.

Having a serious allergic reaction (called anaphylaxis).

Having a severe hemolytic reaction. This is where the donor
red blood cells are destroyed.

Being infected with a virus such as HIV or Hepatitis.
It is more common to experience mild side effects from the
transfusion, such as an itchy rash, fever or chills. Most people who
receive a transfusion don’t experience any side effects at all.
9
Many people are concerned about being infected with a disease
like HIV or Hepatitis through a blood transfusion. This is extremely rare.
For example, the risk of receiving red blood cells infected with HIV is 1
in 4.7 million.
Virus
Risk
HIV
1 in 4.7 million
Hepatitis B
1 in 82,000
Hepatitis C
1 in 3.1 million
Source: Callum JL and Pinkerton PH. Bloody Easy 2: Blood
Transfusions, Blood Alternatives and Transfusion Reactions: a
Guide to Transfusion Medicine, 2nd Ed. Sunnybrook and
Women’s College Health Sciences Centre, Toronto, ON,
2006; 32.
The risk of receiving an infected red blood cell is much lower than the
risk of being killed in an automobile accident.
Event
Risk
Fatal car accident
1 in 11,000
Fatal fall
1 in 14,000
Source: Statistics Canada. Mortality – Summary list of causes, 2004.
Available at: www.statcan.ca
Canada’s blood supply is one of the safest in the world!
10
Are there any alternatives to having a blood
transfusion?
If you require elective surgery (your surgery is scheduled well in
advance), your surgeon and family doctor will work together to
ensure that you are as healthy as possible. The stronger that you are
going into surgery, the less likely it is that you will need a blood
transfusion.
If you are found to be anemic (you have low numbers of red blood
cells in your body), your doctor may give you iron pills to “build up
your blood”. People who are anemic going into surgery are more
likely to need red blood cell transfusions than people who are not
anemic. If you are very anemic, your doctor may also give you a
medication called erythropoietin to stimulate your body to produce
new red blood cells. It takes several weeks for these medications to
have their effect.
Before your surgery, if your surgeon tells you to stop medications such
as Aspirin®, Plavix®, Ibuprofen (Advil®), Warfarin (Coumadin®) or any
other drugs, it is important for you to stop taking them. These drugs
can affect platelet function.
If you have any questions about how medications affect the function
of your platelets, please ask your physician.
Other means of conserving blood are Acute Normovolemic
Hemodilution (ANH) and Intraoperative Cell Salvage.
ANH is performed by the anesthesiologist in the operating
room while the patient is unconscious. If necessary, the
anesthesiologist can remove whole blood from the patient,
and replace it with saline (a salt solution). This is called hemodilution because the saline dilutes the patient’s blood. The
blood that was removed is stored in the operating room with
the patient. If the patient bleeds, the anesthesiologist returns
their own blood back to him or her. Usually, you need to be
a healthy person to undergo this procedure. Discuss any
questions you have with your surgeon or anesthesiologist.
Intraoperative cell salvage is another means of giving the
patient’s own blood back to them at the time of surgery. In
this process, blood that is lost by the patient during surgery is
collected, filtered and returned to the patient. Up to 80% of
blood lost can be recovered. This procedure is not
11
appropriate for everyone. For example, patients undergoing
surgery for cancer may not be able to undergo this
procedure. Intraoperative cell salvage also has some
specific risks to the patient associated with it. If you wish to
consider intraoperative cell salvage, it is very important to
discuss this therapy with your surgeon.
It is important to discuss your feelings about blood transfusion with
your surgeon and your family doctor. If you have more questions
about alternatives to transfusion, or you have religious or other
objections to blood transfusion, your doctor may refer you to a
specialist with expertise in transfusion medicine.
Does artificial blood exist?
No. Most often when people think about artificial blood, they
imagine something that doesn’t contain any blood, but still carries
oxygen throughout the body. Scientists haven’t yet been able to
design a product like that.
There are products called blood substitutes but they are NOT
licensed for clinical use (not licensed to be given to patients) in either
Canada or the United States.
Can I donate my own blood?
This is called an autologous blood donation
(donation for yourself). Your physician must
make arrangements with Canadian Blood
Services in 4 to 6 weeks in advance of your
surgery date in order for you to make your
own blood donation. This blood is marked
only for your use. It will not be used by any
other patient if you do not require a
transfusion. Using autologous blood can
eliminate the risk of transmissible disease or
antibody production to donor blood. If you
require more blood than you donated, you
may have to receive blood from other
donors. Please discuss this with your doctor.
12
Can I donate for a family member or friend?
This is called a directed donation (donation for a specific person).
Currently in Saskatchewan, parents who are eligible may provide
their blood for their children. This must be arranged through your
physician and Canadian Blood Services and is not available in
emergency situations. Usually these donations occur 4-6 weeks
before a pre-booked surgery. Directed donations, like autologous
donations, are only used for the specific patient. They can not be
given to others.
How will I know if I received a transfusion?
You will receive notification when you are discharged from the
hospital. It may be a letter or card that states that while you were in
the hospital you received red blood cells and/ or a plasma
component. This letter or card helps the hospitals and Canadian
Blood Services track where, when and what blood products you
received. Please retain this document for your personal health
information.
13
I never knew that blood was so important!
How do I become a blood donor?
If you would like to donate blood, please contact Canadian
Blood Services at 1-888-2-DONATE (1-888-236-6283).
I would love to help, but I can’t donate blood!
Even if you can’t donate blood you can still help by donating
your time and enthusiasm! Volunteers are essential to the success
of Canadian Blood Services. Volunteers greet donors and assist
them through the donation process, offer refreshment and
thanks after donation, recruit donors, coordinate blood clinics in
their communities and much more!
To become a volunteer, contact Canadian Blood Services at
1-888-2-DONATE (1-888-236-6283).
14
Contact Information
Transfusion Safety Officer
Saskatoon Health Region
B687 RUH
103 Hospital Drive
Saskatoon, SK S7N 0W8
Phone (306) 655-0988
Fax (306) 655-0987
Cell (306) 381-6687
Bibliography
1.
Callum JL and Pinkerton PH. Bloody Easy 2: Blood
Transfusions, Blood Alternatives and Transfusion Reactions: a
Guide to Transfusion Medicine, 2nd Ed. Sunnybrook and
Women’s College Health Sciences Centre, Toronto, ON,
2005.
2.
Canadian Blood Services data: the Canadian Blood
Services Utilization Report, 2006
3.
Petrides M and Stack G. Practical Guide to Transfusion
Medicine. AABB Press, Bethesda, MD, 2001.
4.
Clinical guide to transfusion medicine. Canadian Blood
Services, 2006.
15
Notes or Questions to Ask My Physician
16